Nebulaskin delivers improvements to the skin without the damage of conventional technologies.

Fourth State is proud to have its researchand development supported by the British Skin Foundation.

Plasma is the fourth state of matter (solid, liquid, gas, plasma). Think of the sun, lightning or the Northern Lights and you can see plasma in action. Not all plasma treatments are the same, and no-one in the market knows this more than Fourth State, having spent their professional lives developing advanced plasma systems. This gives Fourth State a unique perspective and the capability to select the best form of plasma to give the practitioner unrivalled control and provide the best possible results for patients.

The technology consists of two components, a base unit that sets up and controls the treatment and a hand piece that administers the energy jet to where the practitioner is aiming. To treat an area, the practitioner directs the handpiece to the area to be treated and guides the visible energy spot over the surface to deliver a single pass of energy. A single pass treatment creates a very mild treatment resembling a mild sunburn. For deeper features, repeat passes may be necessary in which case the process is repeated to allow for deeper energy penetration.

Clinicians will see immediate feedback on the treated area which will redden and require application of moisturising creams during the healing process. During the treatment the hygienic spacer maintains the gap between our plasma generator and the skin and is disposed of after each patient.

Nebulaskin uses the unique thermal properties of plasma to allow precise quantities of energy to be deposited on the skin surface through an inert gas jet. The use of an inert gas which simultaneously removes oxygen from the area and prevents charring and blackening of the skin surface. This unique ability prevents the skin becoming delicate after the treatment and during the healing period. The energy from the gas jet diffuses through the skin and is deposited subdermally which creates the required subdermally modification. This process prompts the body’s healing response and the healing process can begin underneath the old epidermis dressing.

Nebulaskin represents a true innovation in minimally invasive cosmetic surgery. No other technology provides practitioners with the freedom to develop their treatment intuition while allowing for a full spectrum of treatment depths from minimally invasive to resurfacing in a treatment time that keeps discomfort to a minimum and keeps your practice moving.

Clinical Results

Nebulaskin enables delivery of energy to the skin without removing the epidermis or degrading the collagen and elastin underneath. Clinical evaluations of the Nebulaskin treatment have been conducted on human tissue (shown below). These evaluations demonstrated an even distribution of sub-dermal energy which can be seen highlighted by the dark staining in the post treatment elastic van Gieson (EVG) histology slide below. This slide also clearly shows that the epidermis is still in place with minimal separation, creating the perfect wound dressing for a fast recovery.

The Nebulaskin treatment has been designed to create minimum disruption to the skin structure while causing sufficient sub dermal modification to inspire a healing response and create new skin. This approach allows for the preservation of the pigment cells surrounding hair follicles. During the healing process the pigment cells redistribute to the surface of the skin reducing the risk of hypo-pigmentation. The preservation of the pigment cells is highlighted in the S100 stain shown below.

Figure 1: Haematoxylin and Eosin (H and E) stain of normal skin as control. There is a clear distinction between the dermis and epidermis. The epidermis shows keratin flaking from the surface. The dermo-epideroid junction is clearly defined and there are healthy rete pegs separating the papillary and reticular dermis

demarcated injury with loss of collagen but retention of elastin stain extending into the reticular dermis, mild flattening of the rete pegs and superficial oedema at the basal layer

Figure 2: HP, H and E stain of skin treated with 1 second plasma exposure of equivalent to 25 joules (LP and HP). The basal epithelial cells have become oedematous along the line of the basal epithelium. The oedematous cells are elongated and deformed perpendicular to the skin. There is a subtle colour change in the papillary dermis

The technology consists of two components, a base unit that sets up and controls the treatment and a handpiece that administers the energy jet to where the practitioner is aiming. To treat an area, the practitioner directs the handpiece to the area to be treated and guides the visible energy spot over the surface to deliver a single pass of energy. A single pass treatment creates a very mild treatment resembling light sunburn. For deeper features, repeat passes may be necessary in which case the process is repeated to allow for deeper energy penetration.

Clinicians will see immediate feedback on the treated area which will redden and require application of moisturising creams during the healing process. During the treatment, the hygienic spacer maintains the gap between our plasma generator and the skin and is disposed of after each patient.

Nebulaskin uses the unique thermal properties of plasma to allow precise quantities of energy to be deposited on the skin surface through an inert gas jet. The use of an inert gas which simultaneously removes oxygen from the area

and prevents charring and blackening of the skin surface. This unique ability prevents the skin becoming delicate after the treatment and during the healing period. The energy from the gas jet diffuses through the skin and is deposited subdermally which creates the required subdermally modification. This process prompts the body’s healing response, and the healing process can begin underneath the old epidermis dressing.

Nebulaskin represents a true innovation in minimally invasive cosmetic surgery. No other technology provides practitioners with the freedom to develop their treatment intuition while allowing for a full spectrum of treatment depths from minimally invasive to resurfacing in a treatment time that keeps discomfort to a minimum and keeps your practice moving.

Fourth State is proud to have its research and development supported by the British Skin Foundation.

A genuinely new plasma approach to minimally invasive cosmetic surgery.

Benefits

Quick and efficient treatment

No charring of the skin

Energy delivery is skin tone independent.

High repeatability and consistent energy delivery

Provides for minimally invasive and resurfacing capabilities.

Non-slip foot switch or integrated hand piece activation switch

Simple setup and user friendly touch screen interface

No harmful reflections and treatment room requirements

Application

Removal of rytids fine lines and wrinkles

Perioral and periocular treatments

Smoothing of acne scars

Regeneration of epidermis, elastin and collagen

Consumables

Three easy to use consumable elements

Treatment cores last 10 patients - fit at the start of your patient list and use for the rest of the day

Conveniently sized gas cartridges are easy to install and recyclable

Low cost and hygienic patient interface spacers click into place and rotate into convenient positions